Provider Demographics
NPI:1588031413
Name:MONTZ, CHRIS (ABOC)
Entity Type:Individual
Prefix:
First Name:CHRIS
Middle Name:
Last Name:MONTZ
Suffix:
Gender:M
Credentials:ABOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23050 MCAULIFFE DR
Mailing Address - Street 2:
Mailing Address - City:ROBERTSDALE
Mailing Address - State:AL
Mailing Address - Zip Code:36567-3122
Mailing Address - Country:US
Mailing Address - Phone:251-947-4300
Mailing Address - Fax:251-947-4365
Practice Address - Street 1:23050 MCAULIFFE DR
Practice Address - Street 2:
Practice Address - City:ROBERTSDALE
Practice Address - State:AL
Practice Address - Zip Code:36567-3122
Practice Address - Country:US
Practice Address - Phone:251-947-4300
Practice Address - Fax:251-947-4365
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL166713156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician